CLINICAL OUTCOME FOLLOWING ARTHROSCOPIC STABILIZATION WITH CAPSULAR PLICATION (A PRELIMINARY REPORT)

Abstract

The purpose of this study was to examine clinical outcomes of capsular plication using subjective outcome measures and objective clinical examination with emphasis on range of motion. Data of consecutive patients (twenty-five at six months and twenty at twelve months) who required arthroscopic stabilization over a period of three years were retrospectively reviewed. At six and twelve month post-operatively, the disease specific outcome measure, ASES, and relative Constant, showed significant changes in quality of life. There was no loss of external rotation at 0° and 90° of external rotation at one year post-operatively.

The purpose of this study was firstly to assess the effectiveness of capsular plication, in the treatment of instability related pathology, using subjective outcome measures and secondly to look specifically at the effect of this procedure on range of motion.

Suture capsular plication has been advocated as a less invasive technique to reduce symptomatic capsular laxity with less morbidity than traditional open techniques. There is, however, little evidence that this procedure has the same clinical effectiveness as open capsular shift procedures.

Arthroscopic capsular plication improves quality of life (QOL) in patients suffering from shoulder instability without significantly restricting external rotation.

Data of consecutive patients who required arthroscopic stabilization over a period of three years were retrospectively reviewed. Three outcome measures were used; one disease-specific and two shoulder specific measures:

1. the American Shoulder & Elbow Surgeons standardized shoulder assessment form and,

2. the Constant-Murley.

Analysis involved a paired T test between the means of each outcome measure pre and post-surgery.

Twenty-five patients had complete pre-op and six- month post-op data. Twenty subjects had complete pre-op and twelve- month post-op data. At six month post-operatively, the disease specific outcome, relative Constant, and ASES showed significant improvement in QOL scores (P< 0.000, 0.006, and, 0.004 respectively). At twelve- month post surgery, change in all measures remained statistically significant. There was no loss of range of motion in external rotation at 0° or 90° of abduction between initial and follow up assessments in the clinic.

Funding: This study was supported by the research funds of the Orthopedic & Arthritic Institute, Sunnybrook and Women’s College Health Sciences Centre.